Date of Award

2013

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

Abstract

Spirituality has been identified as a unique construct with relationships to quality of life and adjustment to severe illness. Differentiating the characteristics of spirituality from religiousness and identifying the dimensions within spirituality will improve understanding of the relationships with health related outcomes and facilitate targeted interventions. The Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp) is a widely used measure of religiousness and spirituality among cancer patients. Original factor analysis of the FACIT-Sp supported two factors: Faith and Meaning/Peace. A three-factor solution has been identified that divides the Meaning and Peace factor into cognitive and affective components. This study further explored the factor structure for the FACIT-Sp in a group of patients with a cancer diagnosis and receiving active treatment (N = 240). CFA analysis showed the Fit indices indicated the 3-factor model was a good-fit [(χ2 = 101.49 (df = 49), NFI = .95, CFI = .97, RMSEA = .07] and was an improvement over the 2-factor model that approached but did not obtain a good-fit [χ2 = 160.72 (df = 51), NFI = .91, CFI = .92, RMSEA = .10] with the data. SEM using the 3-factor model demonstrated the Meaning and Peace factors had significant paths with depression on BSI (β = -.44, p ≤ .01 and -.37, p ≤ .01 respectively). SEM using the 3-factor model and QoL measures demonstrated predictive ability after controlling for depression: Meaning paths with Socfmwb and Emotwb (β = .46, p ≤ .01 and -.36, p ≤ .05 respectively); Peace paths with Physwb, Emotwb, and Funcwb (β = .30, p ≤ .05; .43, p ≤ .001, .38 ≤ .001) with QoL measures on the FACT G. The relationships of the separate factors were obscured when combined in the 2-factor model demonstrating significant paths with all four QoL scales and all in the positive direction. The combined Meaning/Peace factor (β = .19, p ≤ .05) substantially altered the opposing relationship between Meaning and Peace with Emotwb. The separated Meaning and Peace scales did not demonstrate convergent and divergent validity with the similarly aligned scales, Will-to-Meaning scale from the LAP-R and the Peace scale from the Ironson and Woods Religiosity Index. The Meaning and Peace scales also demonstrated predictive value in relationship with negative and positive religious coping as measured by the R-COPE. These results provide support for the improved fit and added utility of a 3-factor model for the FACIT-Sp.

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